Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Factors Influencing Duration

Length of disability depends on the location and number of affected discs, and whether nerve root compression has resulted in cervical radiculopathy. Other factors include the severity of any neurological involvement, and whether these neurological deficits are improving, static, or worsening over time. The individual's age and whether surgery was performed are important factors influencing the duration of disability. Psychosocial factors, including the individual's attitude and willingness to return to work and to comply with a home exercise program contribute to the outcome. Dependence on pain medications can be an important factor influencing duration for some individuals, especially if the employer has a policy precluding use of controlled substances in those with safety sensitive jobs.

Medical Codes

Overview

&COPY; Reed Group

Displacement of a cervical intervertebral disc refers to protrusion or herniation of the disc between two adjacent bones (vertebrae) of the cervical spine in the neck (vertebrae C2 through C7). Note that there is no disc between the skull and C1 or between C1 and C2. Although displacement is commonly referred to as a slipped disc, the disc does not actually slip.

The discs between each vertebra form a cushion that absorbs shock and allows movement of the neck. The discs are composed of an inner gel-like material (nucleus pulposus) and an outer ring of tough, fibrous material (annulus fibrosis). Sometimes the fibrous material develops a weak area that allows the nucleus pulposus to intrude into the spinal canal (disc displacement or herniation). Depending on the site of the intrusion, the disc may compress either the spinal cord or the exiting nerves, or both. Pressure on an exiting cervical nerve root where it exits the spinal canal can cause changes in sensory (touch, pinprick, temperature), motor (muscle strength), and reflex function in the innervated areas (upper limb). These types of changes are collectively referred to as radiculopathy; however, disc displacement may also occur without radiculopathy. Cervical radiculopathy also may be caused by tumors, infection, or vertebral fracture. Disruption of the annulus fibrosis itself may also cause symptoms (annular disruption, distension, or tear). This can allow the nucleus pulposus to leak out of the disc, causing an intense and painful chemical inflammation (radiculitis).

Disc herniations (commonly called "soft discs" in the neck) tend to occur in younger adults who have only mild loss of disc height (disc degeneration) and thus have enough disc material still present to produce a protrusion or herniation. The same radiculopathy symptoms and signs on exam can be produced without a disc herniation in older individuals who no longer have enough disc height (disc material) to produce a herniation, but rather have arthritic spurs (osteophytes) as the structure that pinches the nerve root. In these older individuals the term used to indicate the cause of the radiculopathy is "hard disc," meaning bone spur or "bony bar."

The most common sites of disc displacement are between the fifth and sixth (C5-C6) or the sixth and seventh (C6-C7) cervical vertebrae. These two levels have the most movement, thought to be a contributing factor. Cervical intervertebral disc displacement usually occurs as a result of age-related physiological changes leading to progressive degeneration of the cervical spine; it is rarely the result of a single traumatic injury. Age-related changes may begin as early as the second decade in life. Disc degeneration can result in looseness (hypermobility) of the affected vertebral segment, leading to instability of the cervical spine, osteoarthritis, or both. Individuals with degenerative cervical disc disease are frequently genetically predisposed to develop lumbar disc disease. Degenerative disc disease can result in spinal cord compression (myelopathy), but this is uncommon.

Incidence and Prevalence: About 8% of all herniated discs occur in the cervical region of the spine ("Herniated Nucleus Pulposus"). Among pain-free (asymptomatic) individuals, herniated cervical discs are observed by MRI in 10% of adults younger than 40 years and in 5% of those older than 40. Displaced cervical discs occur as often in men as in women (Furman).

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